A&p Unit Ii The Heart

Front 1

where is the heart located

1. in the

2. superior to the

3. anterior to the

4. posterior to the

5. between the

Back 1

1. mediastinum

2. diaphram

3. vertebral column

4. sternum

5. lungs

Front 2

1. weight of the heart

2. length in cm of the heart

3. where is the heart on the ribs

Back 2

1. 250-350 grams

2. 12-14 cm

3. 2nd rib to the 5th intercostal space

Front 3

what is the heart inclosed in

Back 3

a double walled sac

Front 4

what are the layers of the CT linings of the heart

Back 4

1. outer fibrous pericardium

2. inner serous pericardium

3. parietal layer

4. visceral layer

Front 5

fibrous pericardium

Back 5

outer 1st layer of the heart that protects, anchors, and prevents over filling

Front 6

serous pericardium

Back 6

2nd layer of the heart that contains the parietal layer and visceral layer

Front 7

parietal layer

Back 7

underlines the fibrous layer and folds over to form the visceral layer

Front 8

visceral layer

Back 8

also called the epicardium, contains 2 layers with stuff in between them. It's directly over the heart tissue

Front 9

pericardial cavity

Back 9

found in between the parietal layer and the visceral layer that contains serous fluid for lubrication

Front 10

serous fluid

Back 10

found in the pericardial cavity for lubrication during contraction

Front 11

pericarditis

1. what is it

2. what does it lead to

3. how is it found

4. what can it cause

Back 11

1. inflammation of the pericardial cavity

2. reduced serous fluid and friction

3. able to be heard w/ a stethoscope

4. adhesions, fluid retention, and pressure or restriction of movement

Front 12

define cardiac tamponade

Back 12

when the heard cannot properly move because of pressure or restriction

Front 13

What are the cardiac layers

Back 13

1. epicardium (visceral layer)

2. myocardium

3. endocardium

Front 14

myocardium

Back 14

made of cardiac fibers connected by a CT fibrous skeleton made of collagen and elastin

Front 15

CT skeleton

Back 15

made of collagen and elastin and acts as anchors for cardiac fibers

Front 16

what does the myocardium functionally do

Back 16

insulates atria and ventricles

Front 17

Endocardium

Back 17

inner most lining of the heart/ touches the heart tissue

Front 18

atria

Back 18

one of the 2 types of chambers in the heart, the top 2 chambers

Front 19

inreratrial septum

Back 19

internally separates the 2 atria and is electrically conductive

Front 20

inner posterior surface

Back 20

somewhat smooth in appearance

Front 21

pectinate muscles

Back 21

rigid muscles on the anterior wall of the heart

Front 22

cristae terminalis

Back 22

separates the regions in the heart

Front 23

fossa ovalis

Back 23

the depression in the interatrial septum

Front 24

fossa ovalis in a fetus

Back 24

called the foramen ovale

Front 25

right atrium

Back 25

receives de-oxgenated blood from the superior and inferior vena cava and the coronary sinus

Front 26

location of superior vena cava

Back 26

superior to the the diaphragm

Front 27

location of the inferior vena cava

Back 27

inferior to the diaphragm

Front 28

coronary sinus

Back 28

vein coming from the myocardium

Front 29

left atrium

Back 29

receives oxygenated blood from the 4 pulmonary veins

Front 30

interventricular septum

Back 30

separates the 2 ventricles

Front 31

atriovetricular groove/coronary sulcus

Back 31

marks the boundaries of the atria from the ventricles and by circling the heart and contains the coronary arteries

Front 32

define coronary arteries

Back 32

veins that go to the myocardium

Front 33

anterior and posterior inter-ventricular sulci

Back 33

marks the boundaries between the left and right ventricles and contain the inter ventricular arteries/veins

Front 34

papillary muscles

Back 34

valves that project into the cavity and discharge blood

Front 35

Pulmonary circuit

Back 35

the right side carries deoxygenated blood rom tissues to the heart to the lungs

Front 36

pulmonary circuit route

Back 36

venules, veins, superior and inferiour vena cava, right atria, right ventricle, pulmonary arteries, capillaries, lungs

Front 37

systematic circuit

Back 37

left side carries oxygenated blood from the alveoli to the heart to the body tissues

Front 38

systematic circuit route

Back 38

venules, pulmonary veins, left atrium, left ventricle, aorta, material tree, capillaries, cells

Front 39

why is the left ventricle larger?

Back 39

to accommodate for the larger requirements

Front 40

coronary arteries

1. comes from what

2. lies where

Back 40

1. the systematic circuit

2. atrioventricular grove

Front 41

left coronary

Back 41

runs left and divides into the anterior inter ventricular artery and the circumflex artery

Front 42

anterior interventricular artery

Back 42

supplies interventricular septum and anterior walls of ventricles

Front 43

circumflex artery

Back 43

supplies left atrium and posterior left ventricle q

Front 44

right coronary

Back 44

runs right and divides into marginal artery and posterior interventriular artery

Front 45

marginal artery

Back 45

supplies the lateral right

Front 46

posterior interventrical artery

Back 46

runs toward the apex, supplies the posterior ventricles, and connects with the anterior inter ventricular artery

Front 47

cardiac veins

Back 47

collect the venous blood and forms the coronary sinus

Front 48

coronary sinus

Back 48

delivers blood into the right atrium via the great cardiac vein, middle cardiac vein, small cardiac vein, and anterior cardiac vein

Front 49

anterior cardiac veins

Back 49

empties directly into the atrium

Front 50

what is/ causes ischemia

Back 50

a reduced coronary supple that causes the symptoms of angina pectoris

Front 51

ischemia in males

Back 51

pain in the left pectorals with radiation into the left axilla and arm

Front 52

ischemia in females

Back 52

similar to males or stomach pain with nausea

Front 53

what can ischemia cause

Back 53

blockages, cell death, infarct, and the heart attack

Front 54

treatment for ischemia

Back 54

by pass surgery and stints

Front 55

by pass surgery

Back 55

allows closed and blocked arteries to be replaced by veins taken from a patient thighs

Front 56

stints

Back 56

mesh like structures inserted into closed arteries which expand and restore normal lumen and flow

Front 57

atrioventricular valve

Back 57

prevent backlash of blood into the atria during ventricular contraction

Front 58

right atrioventricular valve

Back 58

called the tricuspid valve and has 3 flaps

Front 59

left atrioventricular valve

Back 59

called the bicuspid/mitral valve and has 2 flaps

Front 60

chordae tendinae

Back 60

anchors atrioventricular valve to the papillary muscles to prevent flaps from folding into the atria

Front 61

Mitral Valve Prolapse

Back 61

fluttering dysfunction of the valve flaps (chords tendinae) that is associated with stress

Front 62

semilunar valve function

Back 62

prevents backlash into the ventricles

Front 63

semilunar valves

Back 63

pulmonary and aortic

Front 64

flaps during contraction

Back 64

open in to the pulmonary artery and aorta

Front 65

flaps during relaxation

Back 65

the back flow of blood closes them

Front 66

cardiac muscle

Back 66

striated, a-mitotic, brach, uninucleate

Front 67

intercalated discs

Back 67

how cardiac muscle cells are connected

Front 68

desmosome

Back 68

type of intercalated disc that prevent separation

Front 69

gap junction

Back 69

type of intercalated disc that allows the passage of ions and facilitates the contraction of cells in the same chamber

Front 70

endomysium

Back 70

connects cells to CT skeleton acting as an origin and insertion for cells to anchor to

Front 71

does cardiac muscle have capillaries

Back 71

yes an extensive network intermeshed

Front 72

mitchondria

Back 72

large ones branched in myofibrils

Front 73

functional syncytium

Back 73

describing cardiac muscle because it acts as a single unit

Front 74

autorythmic/ automatic cardiac fibers

Back 74

the 1% of cardiac cells that are self excitable and can initiate their own depolarizations to help pace the heart

Front 75

define nerve stimulation

Back 75

the skeletal requirement of having all the cells in a chamber to contract as an organ or not at all

Front 76

refractory period

Back 76

as long as contract to ensure claim is cleared from the sarcomeres

Front 77

effects of ischemia

1. cannot function properly in __

2. rising levels of __

3. low level of ___

4. inhibited ____ synthesis

Back 77

1. anaerobic conditions

2. lactic acid

3. pH

4. ATP

Front 78

effects of ischemia

1. ___pump fails

2. ___ and ___ levels rise

3.___ junctions close

4. cells

Back 78

1. calcium

2. calcium and H+

3. gap

4. electrically isolating

Front 79

effects of ischemia

1. ischemia areas

2. ___ of electrical conduction

3. chamber failure

4. injured cells release

Back 79

1. infarcts

2. irregularities

3. heart attack

4. creatine kinase

Front 80

is heart contraction intrinsic or extrinsic?

Back 80

intrinsic

Front 81

is heart contraction independent or dependent of the CNS?

Back 81

independent

Front 82

what is the heart controlled by?

Back 82

the extrinsic factors of the CNS and ANS

Front 83

intrinsic cardiac conduction system components

Back 83

composed of the 1% authrythmic cells (senatorial node, atrioventricular node, atriavetrcular bundle of his, left and right bundle, purkinje fibers)

Front 84

autorythmic cells

Back 84

has their own rate of depolarization

Front 85

sinoatrial node

Back 85

to the right of the atria wall and inferior to the vena cava

Front 86

atriovenricular node

Back 86

inferior to the interatrial septum and above the bicuspid

Front 87

atrioventricular bundle of his

Back 87

inferior to the interatrial septum and splits into left and right

Front 88

right and left bundle branches

Back 88

interventricular septum towards apex

Front 89

purkinje fibers

Back 89

interventricular septum into the apex and superior into the ventricular walls

Front 90

function of the intrinsic cardiac condition system

Back 90

initiate and distribute impulses through out the heart to ensure proper depolarization and contractions

Front 91

pacemaker potential (pre potential)

Back 91

sine the autorythmic cells have an unstable resting potential, K+ and Na+ leak into the channels allowing the membrane to drift towards threshold

Front 92

what does the pacemaker potential cause

Back 92

a drop in electronegativity which opens the Ca+ gates

Front 93

what is the dominant autorythmic group

Back 93

the sinoatrial node

Front 94

when does the sinoatrial node depolarize

Back 94

100/min

Front 95

what does the sinoatrial node create?

Back 95

the sinus rhythm

Front 96

what role does the sinoatrial node play in the sequence

Back 96

depolarization wave spreads via the gap junctions and the inernodal pathway to the atria and atrioventricular node

Front 97

what role does the atrioventricular node play in the sequence

Back 97

its the place where impulse delay allows for the atria to contract

Front 98

what role does the atrioventricular bundle of his play in the sequence?

Back 98

since the atria and ventricles aren't connected by gap junctions, the electrical connection conducts the depolarization wave to the right and left bundle branches

Front 99

what role do the purkinje fibers play in the sequence?

Back 99

they contract papillary muscles prior to ventricular contraction

Front 100

how long does the intrinsic conduction system take?

Back 100

220 ms

Front 101

define arrythias

Back 101

uncoordinated atrial and ventricular contractions

Front 102

types of arrhythmias

Back 102

fibrillation, ectopic focus, and heart block

Front 103

define fibrillation

Back 103

where there is a rapid, irregular phase of contractions resulting in no pumping and defibrillation depolarizes the myocardium by shocking to reset the sinoatrerial node establish a sinus rhythm

Front 104

define ectopic focus

Back 104

when an abnormal pacemaker takes control making the nodes junction rhythm at 40-60/min and having small excitable regions

Front 105

define premature ventricular contractions

Back 105

when the heart has small excitable regions due to caffeine or nicotine and generating impulses faster than the nodes rhythm

Front 106

what is a heart block

Back 106

damage to the atrioventricular node preventing impulses from reaching the ventricles causes them to beat on their own at about 30/min

Front 107

what is the treatment for a heart block

Back 107

an artificial fixed rate pacemaker

Front 108

what is a partial heart block

Back 108

when the heart stop transmitting on its own requiring a pace maker

Front 109

what 2 components make up the extrinsic controls of the heart

Back 109

the sympathetic and parasympathetic

Front 110

sympathetic sequence

Back 110

cardioaccelatory center of medulla > lateral horn of T1-T5 > cervical and thoracic chain > postganlionic fibers > senatorial node and atrioventricular node

Front 111

parasympathetic

Back 111

cardioinhibitory center of the medulla > vagus CN X > postganglionic > sinoatrial node and atrioventricular node

Front 112

EKG

Back 112

composite of all action potentials generated by nodes and contractile cells

Front 113

leads of EKG

Back 113

creates picture of electrical conductivity noted as deflection waves

Front 114

P wave

Back 114

senatorial through the atria creating depolarization followed by atrial contraction that takes .08 seconds

Front 115

increase in the p wave

Back 115

an enlarged atrium

Front 116

QRS complex

Back 116

ventricular depolarization and atrial depolarization that takes .08 seconds

Front 117

Increased Q wave

Back 117

infarct

Front 118

Increased R wave

Back 118

enlarged vent

Front 119

T wave

Back 119

ventricular depolarization that takes .16 seconds

Front 120

increased T wave

Back 120

hyperkalemia

Front 121

T wave indication

Back 121

ischemia

Front 122

P-Q interval

Back 122

start of atrial excitation through ventricular excitation that takes .16 seconds

Front 123

lengthened P-Q interval

Back 123

coronary artery disease

Front 124

S-T interval

Back 124

action potential plateau and the entire myocardium is depolarized

Front 125

S-T interval elevated above base line

Back 125

infarct

Front 126

S-T interval depressed below base line

Back 126

ischemia

Front 127

Q-T interval

Back 127

ventricular depolarization through repolarization

Front 128

lengthened Q-T interval

Back 128

ischemia

Front 129

systole

Back 129

contraction

Front 130

diastole

Back 130

relaxation

Front 131

ventricular filling

Back 131

refers to mid-late diastole

Front 132

steps in ventricular filling

Back 132

1. open atrioventricular valves for 70% of ventricular filing allowing passive flow through atria

2. atria depolarizes and contacts allowing final 30% into ventricles

3. atria distole and ventricles depolarize

Front 133

ventricular systole

Back 133

ventricular contraction

Front 134

steps in ventricular systole

Back 134

1. ventricles contract

2. pressure builds in the atrioventricular valves until it exceeds the pressure of the arteries

3. semilunar valves are forced open

Front 135

isovolumetric contraction phase

Back 135

when the pressure builds in the atrioventricular valves

Front 136

ventricular ejection phase

Back 136

when the semilunar valves are forced open giving the normal blood pressure of 120 mmHg

Front 137

isovolumetric relaxation

Back 137

early diastole/ ventricular repolarization

Front 138

steps in isometric relaxation

Back 138

1.the pressure drops to allow arterial blood to back lash

2. the pressure increases to shut the semilunar valves

3. atrial fillings build pressure until it exceeds the pressure of the ventricles pressure

4. atrioventricular valves open

5. ventricular filling beings

Front 139

total time for a heart to beat/complete a full cycle

Back 139

.8 seconds

Front 140

what are the heart sounds created by?

Back 140

the closing of the valves

Front 141

what is the 1st sound the heart makes

Back 141

the atrioventricular valves shutting in the beginning of systole during the QRS

Front 142

what is the 2nd sound the heart makes

Back 142

the semilunar valves shutting in the beginning go the ventricular diastole during the T wave

Front 143

define cardiac output

Back 143

the total amount of blood propelled by the heart per minute

Front 144

stroke volume equation

Back 144

=total volume after filling-residual volume after contraction

=end diastolic volume - end systolic volume

Front 145

what should the stroke volume equal

Back 145

70 ml (60% of the blood being ejected)

=120ml - 50ml

Front 146

how many liters per minute does the heart pump out

Back 146

50 L/minute

Front 147

what 3 factors can affect stroke volume

Back 147

1. preload

2. contractility

3. afterload

Front 148

define preload

Back 148

also called the frank starling law, is the ventricular stretch

Front 149

steps in preload

Back 149

1. increase in venous blood return

2. increase in end diastolic volume

3. increased cardiac stretch

4. increased actin-myosin cross bridging

5. muscle contraction tension

Front 150

contractility

Back 150

an increase in contractile strength as a function of enhanced Calcium influx resulting from sympathetic stimulation

Front 151

what is after load

Back 151

arterial resistance

Front 152

afterload volumes

Back 152

8mmHg in the pulmonary

80mmHg in the aortic

Front 153

epinephrine

Back 153

comes from the adrenal medulla and is part of the sympathetic nervous system

Front 154

thyroxine

Back 154

effects are longer and are sustained

Front 155

ions found in the heart

Back 155

calcium, potassium, and sodium

Front 156

hypocalcemia

Back 156

low levels of calcium in the body that reduces heart function

Front 157

hypercalcemia

Back 157

high levels of calcium in the blood that causes spastic heart contractions

Front 158

hypernatremia

Back 158

high levels sodium that inhibits calcium transport and muscle contraction

Front 159

hyperkalemia

Back 159

high level of potassium that lowers resting potential leading to heart block and cardiac arrest

Front 160

hypokalemia

Back 160

low level of potassium that leads to weakness and abnormal rhythm

Front 161

tachycardia

Back 161

describes a heart that beats more than 100 beats per minute

Front 162

bradycardia

Back 162

describes a heart that beats less than 60 beats per minute

Front 163

congestive heart failure

Back 163

reduction in cardiac output caused by various things causing dysfunction and degeneration of the myocardium

Front 164

pulmonary congestion

Back 164

left side heart failure when blood backs up engorging the pulmonary capillary bed causing pulmonary edema

Front 165

peripheral congestion

Back 165

right side heart failure when blood backs up in the venous system causing edema in ankles and organs

Front 166

digitalis

Back 166

medicine that is a diuretic and reduces heart rate and blood pressure

Front 167

23rd day of fetus

Back 167

the 2 tubes fuse into a single pumping chamber

Front 168

25th day of fetus

Back 168

4 primitive chambers differentiate

1. sinus venosus

2. atrium

3. ventricle

4. bulbus cordis

Front 169

2nd month of fetus

Back 169

fully developed expect for foramen oval and ductus arteriosus

Front 170

foramen ovale

Back 170

pushes blood from right atrium to left atrium skipping the pulmonary circulation and closes after birth leaving the fossa ovale

Front 171

ductus arteriosus

Back 171

pushes blood from the pulmonary trunk to the aorta and closes after birth leaving the ligamentum arteriosum

Front 172

what are some congenital defects

Back 172

atrial septal defects, patent ductus, ventricle septal defects, coarctation of the aorta, tetralogy of fallot, and cyanosis

Front 173

atrial septal defects

Back 173

when the foramen ovale doesn't close causing mixed blood

Front 174

patent ductus

Back 174

when the ductus arteriosus doesn't close causing mixed blood

Front 175

ventricular septal defect

Back 175

when the septum doesn't form causing mixed blood

Front 176

coarctation of the aorta

Back 176

the narrowing of the aorta (stenosis) causing the heart to pump the blood harder

Front 177

tetralogy of fallot

Back 177

4 defects of the heart all occuring at once

Front 178

cyanosis

Back 178

bluish color of the skin resulting from poor circulation of blood/ common symptom